Pregnancy Update: 34 Weeks/Doctor Debacle

If you’re reading this blog, you probably have enough experience with doctors to know how frustrating and bewildering they can be. Even if you love your doctor, you’ve probably had your share of “wtf” moments with them too.

If I’m really brutally honest, this isn’t really the first time my doctor has let me down. He can be hard to contact and unreasonable about refilling prescriptions if I’m overdue for an appointment – even if I’m scheduled to come in later that week. Nope, you’ll just have to spend 3 or 4 days unmedicated. Oh, and during that time he won’t talk to me either, this news is relayed by nurses. And I often feel rushed through appointments with no chance to ask questions or voice concerns – or he seems to be in such a hurry that I feel like I need to pick the most important question and ask only that one. And honestly, he usually makes me feel silly for asking anything.

So why do I say I like him? Well, I do. I mean as a person, I genuinely like him. He’s funny, we share similar interests, and we’ve known each other for years. When we talk about non-medical things, he really feels like a friend. That’s part of the reason I feel bad asking medical questions, actually. I don’t want to come off as disrespectful or untrusting to this doctor that I genuinely like. And he has been good to me. He’s answered midnight calls and treated my endometriosis well. He’s operated on me three times. I trust him. He also worked with my infertility doctor off the clock to figure out what might work best for my PCOS. I believe he really cares.

But on the other hand, I started seeing him when I was a teenager. So we definitely started out with that “doctor is above patient” relationship – that is, he was a figure of authority and I was a kid. So as an adult, I still feel “less than.” You know what I mean? I still kind of feel like the embarrassed teenager who should just do what the doctor says. But I’m not. I’m actually an award-winning health blogger now who spends a lot of time researching a lot of medical articles on all sorts of things.

So maybe things were doomed to begin with.

What does a health blogger do when she gets pregnant? She reads (and reviews) all sorts of books on pregnancy and birth. She watches documentaries. She reads blogs. She takes all the classes she can. And she does something very controversial: she makes a birth plan.

I know. It’s a joke among doctors and nurses and crazy-talk among the “normal” moms and moms-to-be. It’s the hallmark of a controlling, naive “birthzilla.” I knew that and I wanted to emphasize that I am not one of those crazy moms. I respect the doctors’ and nurses’ training and value their advice. I want to talk things out when we can. But to my mind, it seemed like a good idea to have everything written down because when I’m in labor I may not be the best communicator.

I also wanted to talk through the birth day with my doctor beforehand. I wanted to get an idea of his general protocol and what to expect at this specific hospital with him. I’d already told him I wanted a natural-as-possible birth and while it was clear that was unusual to him he seemed on board. So I just wanted to go in with my husband, hand him the birth plan (such a dirty word. Is “list” better?), and just talk through it.

He begrudgingly took it and put it in my folder without looking at it. He said he’s done so many births that he doesn’t need to read it, he knows what’s on it. He informs us that when our due date arrives we will be induced with pitocin if we haven’t had the baby yet – and he doesn’t know that’s the number one thing we want to avoid because he didn’t look at the list. Not inducing labor is our strongest wish. I understand there are situations where it can’t be helped, but I also know most women go past their due date, so this is basically a scheduled induction for no medical reason.

He went on to say that he always does episiotomies if you start to tear. Never mind that most doctors no longer do routine episiotomies. He does. And again, he doesn’t know I would rather tear than be cut. He doesn’t talk about it like an option – it’s simply a statement of what will be.

Being free to choose positions won’t matter. Walking, access to a shower, I can pretend all I want that I’ll do those things, but in the end I’m going to want an epidural after all and none of my research and thought will matter.

He concludes by saying that almost everyone who comes in with a birth plan ends up in c-section. It’s just bad luck to discuss it before the big day. Yeah, I definitely want to save the decision-making and question-asking for the day when I’m out of my mind because I’m 10 hours in to labor. That sounds great because I’ll probably be unable to understand any complex decisions – that way the doctor gets to do whatever he wants thinks is best.

Husband and I were stunned into mostly silence. We felt we had no control over our birth. What we envisioned as a “special day” was quickly sounding like another surgery day. This person who we felt some degree of friendship with wouldn’t even read our wishes, much less work with us on them. Husband had taken off of work to talk and ended up being shooed away without any kind of person-to-person communication. We went to lunch and frantically tried to come up with a way out. Was it too late for a birth center? A midwife? Everyone we’ve talked to so far is booked up already.

A couple of days later my husband got a call from the doctor. He said he’d looked over our plan after all and wanted to talk about it. Well, that’s what we wanted to do last time! Husband was quick to say he couldn’t take off of work again, and insisted on an after hours appointment to talk. So that’s on the horizon somewhere. But husband’s currently out of town, and I’m going in for my Strep B test tomorrow.

Pretty sure I’m going to get a talking to about how ridiculous a natural birth would be. Husband is more optimistic. He thinks we’re in for an apology and some real team work from here on out.

I look back on the advice I’ve given on this blog for years. Things like “Don’t be afraid to fire your doctor.” Well, I’ve never been on such a strict medical time table before. If I do need to fire my doctor, I’m not looking at a few weeks/months of staying sick while I look. Baby ain’t waiting.

I am not a high risk pregnancy. I’ve done my research and I know there’s no reason I can’t have a natural birth if that’s what I want to do. I know not everyone wants a natural birth. I know it’s going to hurt. I’ve lived with pain a long time now. I know it well. I know the difference between good pain (the kind that comes from running a marathon or climbing a mountain) and bad pain (the kind that comes from illness and injury). Getting pregnant was so hard for me, and this is likely the only child I’ll have. I may not get another chance to try it and see what it’s like. So if it’s not putting me or the baby in danger… why am I being forced into medication and procedures I don’t want? No, it’s worse than that. Why am I not even getting to be a part of the conversation? Ugh.

At this point I’m feeling so discouraged that I’m positive the comment section is going to fill with people telling me doctors DO know best and natural childbirth is just a dumb fad and why should any of it matter anyhow? In the end you get a baby, and if you tried to do it without a doctor you’d probably get yourself killed. Stop being a birthzilla.

Well I can’t. I’m too passionate about health and advocacy. If I can’t advocate for my birth, how can I keep blogging about patient advocacy? I advocated for better student disability rights at my university. I advocated for myself against doctors who wouldn’t keep me informed about tests of my own health. I’ve fired doctors before. I’ve kept trying until I’ve gotten the help I need before. I don’t have a medical degree, I don’t know better than them, but the doctor-patient relationship needs to be on a more equal level than the mechanic-car relationship.

We’ll see what happens.

Birthzilla or proactive patient? I’m sure you’ll tell me what you think in the comments. 🙂

13 thoughts on “Pregnancy Update: 34 Weeks/Doctor Debacle”

So sorry to hear your doctor doesn’t seem to be listening to you. I haven’t been pregnant yet (still trying to convince my husband it’s a good idea with my health issues) but when/if I do, my thoughts are the same as yours. I know realistically I’ll need to consider all my options but I’d like as natural a birth as possible.

I think you have an absolute undeniable right to discuss a birth plan – that will make both you and your baby most comfortable – with your doctor. It’s a conversation, an exchange of information that needs to be shared. You want X, they suggest Y, you come to conclusion for scenario A and scenario B but in the end you should be leave the appointment feeling as though you’re all on the same page and you have a partner who’s ready to work with you on the big day. I’m sorry that wasn’t your experience and I hope things turn out for the better at your follow up meeting so you, daddy, and baby don’t have the stress of finding someone new. All my love – be seeing you three soon!

Stick to your guns. This is your baby and your body. Your doctor’s plans for you are not evidence-based and could harm you or your baby. Don’t buy into some “birthzilla” stereotype to shame or bully you into giving up your rights to informed consent and informed refusal. If you haven’t found these sites yet, I urge you to check out Evidence-Based Birth, a blog written by a PhD. Nurse Practitioner Academic researcher, and also Childbirth Connection, a website devoted to scientific evidence to support best practices for pregnancy and birth.

If you need help finding a midwife or birth center to accept you as a transfer patient, email me and I’ll connect you with IMPROVING BIRTH, the consumer organization, and with networks of midwives/birth centers. Good luck.

Thank you so much, sorry to just now be writing back! Those sites were great, and I especially fell in love with Evidence Based Birth. It really legitimized my feelings and helped me push for the best birth possible.

Your birth plan is exactly that… Yours. What you decide is important, it is your body and your baby. The benefit is.. that it’s never too late to change doctors, if you are interested, I can give you the name of my midwife and another that I had met with, both are excellent. You should never feel pressured into follow what’s best for the doctor… No one knows you better than you.

It’s so hard to fathom that doctors would recommend things based on what’s best for THEM, when it’s your body that will be sporting the cuts and processing the medication. That’s why it’s so hard to see it happening, and know you need to switch. My doc went from being someone I’ve trusted and known for years to a stranger in two seconds flat. Makes me wonder what else I’ve agreed to under the impression that he really knew best…

Ended up changing doctors on the night of delivery, which was a gamble but our midwife was sure it wasn’t labor and I was sure I didn’t care, SOMETHING was happening. Turns out it was labor. 😉 Healthcare really is just like any other choice, but doctors are really good at making it feel like there are no choices.

ANYWAY. Thank you for your support, it really helped me get through everything I’m ranting about. Healthy baby, healthy mama, and admittedly confusing medical fees and paperwork but worth it in the end.

You are not a birthzilla. Far from it. I can’t say more than that right now. I want to choose my words. I’ve had three pregnancies and three babies (three c-sections), and they were all different (two different doctors and two different hospitals) and all were “perfect” in their own ways. I am very much a “the doctor is always right” person. Definitely stand up for yourself. I will write more later. I promise. But really, don’t worry about my words except everything will be okay and if you’re not a screaming banshee you’re doing just fine. 🙂

I’m sorry, what?? EVERYTHING you’ve said here is PERFECTLY REASONABLE and TOTALLY ACHIEVABLE. I know you’re not stupid, you have a birth plan knowing it’s probably going to go nothing like that in reality, but that doesn’t mean it WON’T. Natural births happen all the time, and they’re not easy, but it is do-able! The most important thing is feeling like you have you have as much control over your DECISIONS on the day as possible, and not been bullied into interventions. Interventions are FINE as long as you are comfortable with them and feel like it’s what you are ready for at the right time. That’s how you have a successful birth.

This was the most empowering comment I got, and at the time it really fired me up to go find a doctor who would work with me instead of a “my way or the highway” doc. Sorry to only just now write back. I remember showing my husband this comment in particular as “see?! We’re not crazy!” Evidence. 🙂 thanks for the boost.